Provider Demographics
NPI:1639898687
Name:SAENZ, ELIZANDRA SOFIA
Entity Type:Individual
Prefix:
First Name:ELIZANDRA
Middle Name:SOFIA
Last Name:SAENZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2030 N 1ST ST
Mailing Address - Street 2:
Mailing Address - City:CARRIZO SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:78834-2028
Mailing Address - Country:US
Mailing Address - Phone:830-255-9780
Mailing Address - Fax:830-876-9156
Practice Address - Street 1:2030 N 1ST ST
Practice Address - Street 2:
Practice Address - City:CARRIZO SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:78834-2028
Practice Address - Country:US
Practice Address - Phone:830-255-9780
Practice Address - Fax:830-876-9156
Is Sole Proprietor?:No
Enumeration Date:2022-08-23
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX306670183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician